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Background: Prevalence of obesity is rapidly rising. To reverse the obesity epidemic, efforts should be made to incorporate intensive weight loss programs into medical practice. The primary aim of this study was to change the behavior for achieving a mean weight loss of 5-10% of initial body weight over 6 months in overweight and obese adults. Methods: In this quasi-experimental study, 266 out of 533 subjects screened for coronary heart disease risk factors in Shiraz Healthy Heart House were overweight or obese. 140 individuals with BMI⩾25 completed this study's 6 month program. The subjects were visited on day 1 and at 2 week intervals and taught intensive lifestyle modification. The subjects who did not lose 5% of their initial body weight after 3 months were assigned to receive 120 mg orlistat three times daily for 3 months in addition to counseling sessions. The main outcome measures were body weight and BMI. Results: The mean weight and BMI of participants were 78.6±10.7 kg and 30±0.2 kg/m2, respectively. Women included 58% of the sample. 110 subjects (78.5%) lost ⩾5% of their initial body weight during 3 months. The Mean weight and BMI loss in these subjects were 7.6±0.8 kg and 2.4±0.3 kg/m2, respectively. Conclusions: Teaching of how to modify lifestyle and to gain more self-control with eating have the major role in reducing weight and BMI. So, training accompanied by continual follow up for performing the instructions could lead to favourable results. [ABSTRACT FROM AUTHOR]